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. 2024 Oct 8;121(41):e2414957121.
doi: 10.1073/pnas.2414957121. Epub 2024 Oct 1.

Estimates of actual and potential lives saved in the United States from the use of COVID-19 convalescent plasma

Quigly Dragotakes  1 , Patrick W Johnson  2 , Matthew R Buras  3 , Rickey E Carter  4 , Michael J Joyner  5 , Evan Bloch  6 , Kelly A Gebo  7 , Daniel F Hanley  8 , Jeffrey P Henderson  9 , Liise-Anne Pirofski  10 , Shmuel Shoham  7 , Jonathon W Senefeld  11 , Aaron A R Tobian  6 , Chad C Wiggins  12 , R Scott Wright  13 , Nigel S Paneth  14   15 , David J Sullivan  1 , Arturo Casadevall  1
Affiliations

Estimates of actual and potential lives saved in the United States from the use of COVID-19 convalescent plasma

Quigly Dragotakes et al. Proc Natl Acad Sci U S A. .

Abstract

In the Spring of 2020, the United States of America (USA) deployed COVID-19 convalescent plasma (CCP) to treat hospitalized patients. Over 500,000 patients were treated with CCP during the first year of the pandemic. In this study, we estimated the number of actual inpatient lives saved by CCP treatment in the United States of America based on CCP weekly use, weekly national mortality data, and CCP mortality reduction data from meta-analyses of randomized controlled trials and real-world data. We also estimate the potential number of lives saved if CCP had been deployed for 100% of hospitalized patients or used in 15 to 75% of outpatients. Depending on the assumptions modeled in stratified analyses, we estimated that CCP saved between 16,476 and 66,296 lives. The CCP ideal use might have saved as many as 234,869 lives and prevented 1,136,133 hospitalizations. CCP deployment was a successful strategy for ameliorating the impact of the COVID-19 pandemic in the USA. This experience has important implications for convalescent plasma use in future infectious disease emergencies.

Keywords: COVID-19; SARS-CoV-2; antibody; convalescent plasma; mortality.

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Conflict of interest statement

Competing interests statement:Klassen S.A., Senefeld J.W., Johnson P.W., Carter R.E., Wiggins C.C., Shoham S., Henderson J.P., Pirofski L.A., Wright R.S., Paneth N.S., Casadevall A., and Joyner M.J. and reviewers Musser J. and Hartmann W.R. were co-authors in a review/position paper dealing with the use of CCP published in 2021.

Figures

Fig. 1.
Fig. 1.
Bayesian estimates of total lives saved with CI given various models of CCP usage and efficiency from July 2020 through March 2021. (A) Summations of estimated lives saved using the most conservative parameters of each model as a function of time throughout the entire period. (B) Estimated lives saved in models 1 through 4 with CI depicted by error bars. (C) Estimated lives saved in model 5 with CI depicted by error bars. (D) Estimated hospitalizations avoided in model 5 with CI depicted by error bars.
Fig. 2.
Fig. 2.
Proposed scheme for the reduction of COVID-19 mortality by CCP. In the United States of America, CCP was used almost exclusively in hospitalized patients, of whom the majority were admitted because of some pulmonary compromise. Hence, the reduced mortality described here is proposed to reflect the subset that were sufficiently early in the course of disease such that the administration of antibody could modify the progression of disease to result in better outcomes. CCP has been shown to have antiviral activity and to be associated with reduced inflammatory mediators including IL-6. According to this scheme, CCP administration led to reduced inflammation that translated into lower mortality for a subset of treated hospitalized patients. Created with BioRender.com
See this image and copyright information in PMC

References

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